Reanimation device

ABSTRACT

A reanimation device consists of a reanimation bag which is placed on the chest of the patient and which has a tube connected to the lungs of the patient, e.g. by a mouthpiece. When the bag is compressed heart massage may be effected through the bag by the operator. Thus, a single person may carry out resuscitation and heart massage alternately.

United States Patent Frimberger May 13, 1975 15 1 REANIMATION DEVICE 3,139,088 6/1964 Galleher 128/147 3,242,921 3/1966 Seeler 128/1465 inventor: Ecka" Fr'mberge" 3,366,133 1/1968 Johannisson 137/102 cramer-Kletlstrflsse 113-8914 3,474,785 10/1969 Jansson 128/145.7 Neubiberg, Germany 3,599,657 8/1971 Maldaus 137/5124 1 Filed: p 12, 1973 FOREIGN PATENTS OR APPLICATIONS [21] Appl. N0.: 350,519 762,285 4/1934 France 128/28 Foreign Application Priority Data Apr. 12, 1972 Germany 2217614 Sept. 20, 1972 Germany 2245993 U.S. Cl l28/145.7; 137/63 R; 25l/625.25 Int. Cl A6lh 31/00 Field of Search 128/145.7, 145.8, 145, 128/146.4,146.5, 146.7, 147, 136,201,202, 28, 44,61,191,196,197, 30, 30.2; 137/102R, 63 R, 512.4, 331, 335 A, 625.2, 625.25;

[56] References Cited UNITED STATES PATENTS 2,284,053 5/1942 Hermann 128/1457 2,615,463 10/1952 Burns 128/1465 A\\\\\\\\\\\\\\\\\ UIIIIIIII Primary E.\'aminerRichard A. Gaudet Assistant Examiner-Henry .I. Recia Attorney, Agent, or Firm-Stevens, Davis, Miller & Mosher [57] ABSTRACT A reanimation device consists of a reanimation bag which is placed on the chest of the patient and which has a tube connected to the lungs of the patient, e.g. by a mouthpiece. When the bag is compressed heart massage may be effected through the bag by the operator. Thus, a single person may carry out resuscitation and heart massage alternately.

13 Claims, 4 Drawing Figures PATENTEB MAY 1 31975 SHEET 10F 2 REANIMATION DEVICE This invention relates to a reanimation device consisting of a compressible and self-expanding reanimation bag, an adaptation piece for the resuscitation channels, a connection tube between the reanimation bag and the adaptation piece and a double valve for resuscitating the patient as well as a suction valve for air supply to the reanimation bag.

In acute circulatory failure, the rightly applied combination of external heart massage and resuscitation delays the biological death of the victim. lt bridges the time between the spontaneous restarting of heart activity and breathing or maintains a sufficient minimum circulation until suitable diagnostic and therapeutic processes can be applied.

The methods of external heart massage were described by Kouwenhoven, Jude and Knickerbocker (J. Am. med. Ass., 173, 1064 to 1067, 1960). They consist in that the clinically dead patient is laid with the back on a hard surface. Then an assistant presses the lower part of the breast bone of the patient with the fists about 60 times per minute 3 to 4 cm downwards. A second assistant resuscitates the patient with the mouth to nose method alternating with the pressing down of the breast bone. By the pressure on the breast bone the heart lying underneath is compressed and thereby the volume of blood located in the heart is expelled, ie a minimum circulation is maintained.

The process has, over the course of the years, been slightly modified by other researchers. In place of mouth to nose resuscitation, mouth to mouth resuscitation can-by used or the patient can be resuscitated via a tube which is led into the wind pipe of the patient. In place of the tube a breathing mask can also be used which seals the mouth and nose tightly from outside. Also the frequency and the depth of the pressing down of the breast bone are sometimes given slightly differently. The principle remains unaltered.

The current state of the art is given as follows by Frey, Hugin and Mayrhofer (Lehrbuch fur Anesthesiologie und Wiederbelebung, SpringerBerlin, 1971). The patient is laid on a solid surface, the operator then presses with superimposed wrists with powerful pressure rhythmically vertically on the lower half of the breast bone. The breast bone should be depressed by at least 5 to 7 cm, by means of which, at a frequency 60 to 80 compressions per minute, blood pressure values of 60 to 100 mm Hg can be registered. As well as this, as noted, the patient is alternately resuscitated. If only one assistant is available, then the patient is alternately resuscitated and massaged by this person.

The alternating operation by one person of heart massage and resuscitation cannot be maintained for very long on account of the great physical effort connected therewith. A further person for helping is, on the other hand, not available in many cases, e.g. at the scene of an accident or at night.

It is accordingly an object of the invention to provide a reanimation device of the type indicated above which does not merely serve to resuscitate the patient but can also be simultaneously used for heart massage, and without difficulties and great effort by a single person, even over a longer time.

The resuscitation device of the type described above is characterised in that the reanimation bag consists of a resiliently elastic material which rapidly returns to its Lil initial position and of which the length of the connection tube corresponds to the distance between an adaptation piece and breast bone in such a fashion that heart massage can be carried out through the bag supported on the breast bone of the patient in a predetermined rhythm, alternating with resuscitation.

The reanimation device according to the invention is characterised by a simple and convenient handling. it also permits, in cases in which a second person is not available for reanimation, for example at the scene of an accident, the carrying out of heart massage and resuscitation with a low degree of effort by a single person.

In the following the mode of action of the reanimation device according to the present invention is described. The patient is laid with his back on a hard surface. The nose of the patient is closed air-tightly. The compressible reanimation bag is laid on the lower half of the breast bone of the patient and the adaptation piece, for example a face mask, a mouth piece or an intubator tube is connected with the mouth or the wind pipe, i.e. eventually with the lungs of the patient. The resuscitation bag, which is laid on the breast bone of the patient, is pressed together with the fists moved against the breast bone, so that the air in the reanimation bag is pressed out and blown into the patient via the connection tube, the double valve and the adaptation piece. As soon as the reanimation bag is completely collapsed and the flow of air from the reanimation bag into the lungs stops, the double valve automatically goes into its out position in which the air from the lungs of the patient is led outward. The person doing the resuscitating now holds the bag in the collapsed condition with his fists and presses with the fists through the flat compressed bag on to the breast bone a few centimetres in the direction of the spinal column and thus effects heart massage. The breast bone is depressed several times, usually 4 times, before the person doing the resuscitation releases the flat compressed bag and lets it return into its starting position. After the breast bone has been depressed several times and the pressure has been released from the reanimation bag, the bag refills via the suction valve with air from outside. The reanimation bag now is in the starting position again so that the operation just described can be repeated. The operation as repeated is carried out to a suitable rhythm as long as necessary. The ratios between the pressing down of the breast bone and the resuscitation of the patient can naturally also be altered. Thus it is also possible, for example, to press down the breast bone 15 times and then to resuscitate the lungs 4 times with fresh air, before the breast bone is again pressed down 15 times. However usually the patient is resuscitated once for a 4 times depression of the breast bone.

By making the reanimation bag of a resilient elastic material it is guarnteed that the bag rapidly returns to its initial position after the release of the pressure. The rapid return of the reanimation bag to its starting position makes it possible for air insufflation to begin directly after heart massage, and no time is lost during filling of the reanimation bag with fresh air.

The resilient elastic material which rapidly returns to its starting position can be either rubber or a foam rubber corresponding in its properties to rubber or a plastics material. By foam rubber there is to be understood a rubber which is provided with pores closed to the outside and which like normal solid rubber is only deformable by the effect of an outer force, but which cannot be changed in its volume.

The reanimation bag preferably has such a thin wall thickness that the person using the bag can still feel the patient sufficiently through the resuscitation bag. Because of this it is simple for the person doing the resuscitation to put the bag in the right place and to exercise the pressure on the breast bone at the right place.

The reanimation bag can be a longitudinally or a rotationally symmetric hollow body, which is flattened on its support face. By means of this the danger of the reanimation bag sliding or rolling from the correct position during reanimation of a patient is greatly diminished. The person doing the resuscitation thus does not need all the time to keep bringing the bag into the correct position, by means of which valuable time could be lost during reanimation.

The reanimation bag can however also be block shaped or constructed like a bellows. By such shaping the restricted dimensional limitations which are encountered in doctors bags can be well accommodated, since block shaped or bellows type bags can easily be collapsed.

If the reanimation bag according to the invention has a solid plate for localizing the pressure on the breast bone, the pressure can be concentrated on the breast bone and thereby increased.

The reamination bag can, according to the invention, have a loop on the side remote from the support surface for grasping by the hand of the person doing the resuscitating. By means of the this, the resuscitaton bag can be held securely in the hand and even with the fists of the person doing the resuscitation during reanimation. Slipping of the hand or the fist from the reanimation bag is thus avoided. The reamination bag can however be provided in place of a loop also with a mushroom shaped knob, which is accommodated between the fingers of one hand laid flat on the bag, wherein the head part of the mushroom shaped knob lies above the fingers.

The entry valve for the air feed into the reanimation bag can be combined with the double valve for resuscitating the patient into a single constructional unit. By means of this measure the individual parts necessary for making the reanimation device according to the invention can be reduced. The suction valve for air supply into the reanimation bag is set for a very large air flow, in order to guarantee rapid expansion of the bag. The suction valve is also constructed in this fashion if it is not connected with the double valve to form a single constructional unit.

According to an alternative, the reanimation device according to the invention has a matching piece which has a tube on which a first curved element is firmly attached, which can be laid between the teeth and lips of the patient, and on which there is slideably arranged a second curved element, by means of which a clamping device is provided by which the second curved element is pressed on to the lips and can be held firmly. This adaptation piece can be applied without difficulties by a single person. Additionally, this matching piece can be attached to the patients so solidly without any danger of injury that movement of the adaptation piece and thereby any loss of sealing is avoided. This is of particular importance if only one person is available for reanimation, since any rearrangement of the adaptation piece would require the use of valuable time during the reanimation of the patient.

According to a further embodiment of the invention the reanimation device is provided with a double valve serving for the resuscitation of the patient, which has a housing with an opening leading to the outer air, a connection point leading to the patient and a connection point leading to the reanimation bag, which is provided with a tubular stub extending into the housing, on the free end of which are arranged a peripheral flange provided with passage holes and an elastic membrane covering the peripheral flange, which serves for closure of the passage holes of the peripheral flange and of the opening leading to the outer air, wherein the crosssectional area of the tubular stub extending into the housing is the same or greater than the cross-sectional areas of the passage holes of the peripheral flange. The resuscitation valves common in commerce do not work optimally. In the known resuscitation valve the excess pressure in the lead from the reanimation bag to the lungs of the patient can hinder the return position of the valve, so that the air breathed out by the patient cannot reach the outside. In order to enable the patient to breathe out, using a known resuscitation valve, after the pressing down of the reanimation bag the fist must be removed again somewhat from the breast bone in order to let the reanimation bag expand a little in order to give a slight suction effect. The reduced pressure arising by means of the slight elastic expansion of the bag lets the bag return into the outward position so that the air can diffuse outwardly from the lungs of the patient. The known resuscitation valves thus lead to a very inconvenient operation and also bring with them the danger that, with inexpert handling, diffusion of the air from the lungs of the patient, before the heart massage, can no longer take place. This can lead to lung rupture and thereby to a critical injury to the patient.

Using the reanimation device according to the invention with the new double valve such dangers are however eliminated.

Further advantageous embodiments of the reanimation device according to the invention with its double valve are evident from the following description:

In what follows an exemplary embodiment of the invention will be further described with reference to the drawings, in which:

FIG. 1 is a schematic illustration of the reanimation device according to the invention,

FIG. 2 is a schematic illustration of the double valve used in the reanimation device according to the invention in a position in which the air is led from the reanimation bag to the patient,

FIG. 3 is a schematic illustration of the double valve in a position in which the patient breathes out and FIG. 4 is a schematic illustration of a further embodiment of the double valve.

The reanimation device according to the invention has a compressable reanimation bag 1 and a flexible connection tube 3, which is connected via a double valve 4 to an adaptation piece 5 on the breathing passages. The reanimation bag 1 can be filled with air from outside via a suction valve 2. In the embodiment shown in FIG. 1 the adaptation piece 5 is a mouth piece which is later described in detail. The adaptation piece 5 can however also be a face mask or an intubator tube.

The compressable reanimation bag 1 consists of a resilient elastic material, for example rubber, so that the bag returns rapidly and automatically into its original shape after pressing down and the removal of the pressure exercised by the fists. The volume of the reanimation bag is so arranged that a sufficient quantity of air can be fed to the patient. The reanimation bag preferably has such a volume that on compressing about 300 to 1000 cm of air is pressed out.

The reanimation bag can have the form ofa rotation ally symmetric hollow body, which is flatened on its support surface 25. The reanimation bag can however also be formed longitudinally, in a block shape or as a bellows.

In the embodiment illustrated the reanimation bag has a soft airtight elastic shell 6 which surrounds a resilient elastic material 7 such as rubber, foam rubber or a plastics material having corresponding properties to rubber. The resilient elastic material has the form of a hollow body and preferably only a single wall thickness so that the person doing the resuscitating can feel the anatomy of the patient through the collapsed bag. By the use of a resilient elastic material for the reanimation bag it is achieved that the reanimation bag can return very rapidly into its starting position.

The reanimation bag can be provided with a sticky layer or a device allowing its fixing which allows the bag to be fixed to the breast of the patient.

The reanimation bag furthermore has a solid plate 8 for localizing the pressure on the breast bone. This plate can be applied either within or outside the bag. The plate preferably has a size of about 7 X 2.5 cm and consists of solid plastics material which can be somewhat deformable.

The connection tube 3 should be so constructed that both for large and for small patients it enables correct positioning of the reanimation bag above the breast bone. For this, a flexible extendable tube about 35 cm long is preferred. The tube should furthermore have a certain stiffness whereby collapsing is hindered. It can be made of a suitable material such as plastics or rubher.

The suction valve 2 serves for filling the reanimation bag with air from outside. It is preferably combined with the double valve 4 to a single unit.

Air is fed to the patient via the double valve 4, which is preferably located between connection tube 3 and adaptation piece 5 by compressing the bag 1 and the air expelled from the patient is led to atmosphere. This double valve 4 should be easily cleaned. It is therefore advantageous if it can be dismantled and if it consists of an easily cleanable material such as plastics.

The adaptation piece 5 in the breathing channels can take any customary construction. It can be a face mask, a mouth piece or an intubator tube, which is led into the wind pipe of the patient.

A mouth piece is however particularly preferred which has a tube 9 on to which a curved flange 10 is firmly fixed which is laid between the teeth and the lips and on to which a. curved flange 11 is slideably arranged, which can be pressed on to the lips by means of a clamping or securing arrangement 12 and fixed in position.

The tube of the mouth piece can, if desired, be led out via the solidly fixed flange 10. The flanges l0 and 11 are so constructed in size and shape that they guarantee an air tight closure of the mouth. The bent flange 10 is laid between the teeth and lips of the patient and the bent flange 11 which is slideably arranged on the tube is pressed and fixed on the lips by means of the clamping or arresting device 12. The curvature of the flange 10 is suitably less than the human jaw. The curvature of flange 11 is such as to guarantee, in the fixed position, an approximately even distance between the two flanges overall, preferably less than that of flange 10. The flanges can be made of a non-slipping material or can be covered with such, in order that the lips of the patient should not be able to slip out between the flanges. The material should be solid but pliable and easily cleaned and suitably consists of plastics such as polyethylene.

Suitable as a clamping or fixing device is any arrange ment which allows fixing of the slideably arranged flange 11 on to the lips. Preferred however is a fixing device which permits it to be used with one hand for fixing the flange 11, e.g. in the form of a tongue or lever type arrangement so that one hand remains free for pressing away the lips on leading the mouth piece into position.

The double valve 4 and 4' shown in FIGS. 2 to 4 can be arranged corresponding to FIG. 1 between the connection tube 3 and the adaptation piece 5 or between the reanimation bag 1 and the connection piece 3. If the double valve 4 is arranged in the position shown in FIG. 1 then it is avoided that any stale breathed air remains in the connection tube. By means of this it is guaranteed that fresh air, free from used breathed air, is led to the patient. If however the double valve 4 is arranged between the reanimation bag I and the connection tube 3, then the danger is avoided that any intubator tube used is kinked by the weight of the double valve and the air supply to the patient thereby interrupted. Since in this case used breathed air remains in the connection tube it is desirable to make the crosssection of the connection tube 3 as small as possible for diminishing the quantity of used breathed air remaining. The cross-section of the connection tube 3 can amount for example to 0.8 to 1.5 cm

The double valve 4 and 4 shown in FIGS. 2 to 4 consists of a housing 13 which has an opening 14 leading to the outside air and two connection places 15 and 16. Connection place 15 leads to the reanimation bag and connection place 16 leads via the adaptation piece 5 to the patient. The connection place 15 leading to the reanimation bag 1 is provided with a tubular post 17 extending into the housing. A surrounding flange 19 provided with passage holes 18 is provided on the free end of the post 17. An elastic membrane 20 lies around the peripheral flange l9 and the cross-sectional area of the post 17, which is held by means of an elastic ring band 22 in a peripheral groove 21 on the peripheral flange 19. Because of the excess pressure on collapsing the reanimation bag, the elastic membrane 20 is pressed against the post 23 which extends into the housing 13 leading from the aperture 14 leading to the outside air, by means of which opening 14 is closed. The compressed air passes along the passage holes 18 and the connection place 16 to the lungs of the patient. When the reanimation bag is pressed empty, the elastic membrane returns to its rest position, wherein it closes the through openings 18 and frees the passage for the used air to be breathed out through the opening 14 leading to the outer air.

In FIG. 4 a further embodiment of the double valve is shown. In this embodiment the peripheral flange 19' is closed while the elastic membrane 20' has passage holes 18' in the region covering the peripheral flange and is closed at its central portion 24.

The double valve according to the invention works as follows: By depressing the reanimation bag 1 air is led to the patient via the connection tube 3 the attachment position and the tubular post 17 which extends into the housing 13, the passage holes 18 and the connection position 16. Since the small cross-sectional area of the tubular post 17 extending into the housing 13 is greater than the total cross-sectional area of the passage holes 18 of the peripheral flange 19, an excess pressure is built up which pushes the elastic membrane against the opening 14 which leads to the outside air. By means of this, on the one hand the passage holes 18 of the peripheral flange 19 are freed so that the air can flow to the patient and on the other hand the opening 14 which leads to the outside air is closed by the elastic membrane 20. 1f the air stream from the reanimation bag ceases, then the membrane 20 returns elastically to the rest position and thus seals the passage holes 18 of the peripheral flange 19 and opens the opening 14 leading to the external air so that the air can dissipate from the lungs of the patient. Back flow of stale air into the reanimation bag is not permitted. 1f the pressure on the reanimation bag 1 is raised and the bag returns to its starting position, then the bag 1 is refilled with air from outside via the suction valve 2.

In order to push away the elastic membrane 20 from the peripheral flange 19, there must be sufficient excess pressure between the membrane and the flange during the reanimation. This is obtained in that the slight cross-sectional area of the tubular post 17 is greater than the total surface area of the passage holes 18 of the peripheral flange 19. The optimum ratio between the slight cross-sectional area of the post 17 and the total cross-sectional area of the passage holes 18 depends on the returning force of the elastic membrane 20. In any case it must be guaranteed that the membrane 20 tightly closes the opening 14 leading to the outer air if air is to be led to the patient. A ratio of the cross-sectional area of the post 17 to the total crosssectional area of the passage holes 18 between 2:1 and 20:1 has shown itself to be suitable. Particularly, a ratio between 3:1 and 6:1 is preferred.

The shape and number of the holes or openings 18 in the peripheral flange 19 is of no special significance. There can for example be several e.g. 5 to 20 small holes with a diameter of about 0.5 to 2 mm or a few e.g. l to 4 greater openings, these being circular or slit shaped.

The total cross-sectional area of the passage holes 18 in the peripheral flange 19 must, on the other hand, be chosen sufficiently large that not too great a resistance arises to the entry of air, because this would give as a result an unnecessary increase in the power necessary for handling the device. The total cross-sectional area of the passage holes 18 can, for example, lie between 5 and 50 mm The peripheral flange 19 provided with passage holes 18 is generally constructed round and preferably curved slightly convexly towards the opening leading to the outer air, in order that the elastic membrane during breathing out of the patient lies well against the peripheral flange 19 and closes the passage holes 18. The peripheral flange 19 can be made of stainless steel or plastics. The peripheral flange 19 is arranged at a distance from the housing wall 26 in order that the air exiting through the passage holes 18 can easily be led further. The peripheral flange 19 is mounted fixedly on post 17 or removably (e.g. by screwing or fitting). The post 17 itself can likewise be solid or removable (e.g. unscrewable or fixable) in the housing 13.

The elastic membrane 20 can consist of an elastic material such as rubber or plastics. The elastic membrane is removably connected with the peripheral flange by means of the elastic belt 22 which engages in the peripheral groove 21 of the peripheral flange 19, in order that the membrane can easily be exchanged on damage or when it becomes dirty.

According to the variant shown in FIG. 4 the membrane 20 is provided with passage holes 18' which are located in the ring area of the membrane 20, which covers the peripheral flange 19 which has no passage openings. 1f the membrane 20' lies against the peripheral flange 19, then the passage holes 18 are closed by the peripheral flange. Also in this construction the slight cross-sectional area of the post 17 must be greater than the total cross-sectional area of the passage holes 18.

The tubular post 23 on the opening 14 leading to the outside air effects, on the one hand, a sealing closure of opening 14, and on the other protects the elastic membrane from injury.

The distance between the membrane 20 which lies against the peripheral flange 19 and post 23 is so large that the air breathed out by the patient can easily diffuse to outside.

In order to avoid damage to the lungs the pressure in the air passages should not exceed a certain pressure. It is therefore advantageous to provide, on the housing 13, or on the connection position 16 leading towards the patient, an excess pressure valve adjusted to below thecritical pressure.

If the connection position 15 leading to the reanimation bag corresponding to the illustration in FIG. 1 has a suction valve 2, then a suction valve specially ar ranged on the reanimation bag for filling the bag with external air can be dispensed with. Furthermore an inlet valve for the addition of oxygen or oxygen enriched air can be provided, whereby more effective reanimation may be made possible.

The easily dismantleable double valve consists of light and easily cleaned materials such as plastics. The double valve has small dimensions. The connection positions l5 and 16 likewise have a diameter of between 0.5 and 2.0 cm.

The only movable part of the double valve 4, 4 is the elastic membrane 20,20 which is the sealing part. The membrane is cheap to manufacture and can easily be changed. The elastic membrane can thereby be changed simply according to choice alone or together with the peripheral flange 19 and the post 17.

The stream of air emerging from the lungs of the patient during breathing out can lead, without difficulty, to slight raising of the membrane 20 lying against the peripheral flange 19, since on the one hand the air coming from the patient enters into the holes 18 from below and exercises a certain pressure from below on the membrane 20 and on the other hand as the air flows from opening 14 a certain suction effect is exercised on the membrane 20. 1f the membrane 20 is somewhat lifted from the peripheral flange 19 during the breathing out, then the clear distance between the membrane 20 and outlet opening 14 diminishes. The diminution of this distance can lead therewith to an undesirable piping tone. In order to avoid any lifting of the membrane from the peripheral flange 19, there can be provided, on the lower side of the peripheral flange 19, a rubber elastic ring 27 with a small returning force, covering the passage holes 18. The ring 27 is fixed with its inner periphery at the post 17 in the direct neighbourhood of the peripheral flange 19. The ring can however also be fixed at the outer periphery of the peripheral flange 19 or on the circular band 22 of membrane 20. The ring can however also be made from one piece with the membrane 20. The ring 27 lies generally on the underside of the peripheral flange 19 and is lifted away by the stream of air going towards the patient from the underside of the peripheral flange 19. The force acting to return the ring 27 is so small that it immediately suffices to lay the ring lightly on the under side of the peripheral flange. The ring 27 which lies lightly on the under side of the peripheral flange is pressed firmly against the under side of the peripheral flange by the stream of air emerging from the lungs of the patient, so that the passage openings 18 of the peripheral flange 19 are closed and thereby the membrane 20 is kept held on the upper surface of the peripheral flange 19. In the place of the peripheral ring 27, any other flat type seal can, however, be used, which closes the passage holes 18 when there is a stream of air coming from the patient, and which in the usual conditions of use is automatically freed.

I claim:

1. In a resuscitation device for an alternative respiration and external cardiac massage of a patient, comprising a compressible and self-expanding reanimation bag, an adaptation piece for the breathing passage ofa patient, a connecting tube connecting said bag to said adaptation piece, a one-way suction valve provided in the assembly defined by said bag and said connecting tube to fill said bag with fresh air during the expansion stroke of said bag, and a double valve provided between said connecting tube and said adaptation piece and adapted to allow the flow of fresh air from said bag into the lungs of the patient when the bag is being compressed, and the re-flow of said air from the lungs of the patient to the ambient air as soon as the bag has reached its collapsed condition, the improvement residing in that said double valve comprises a housing having a first opening leading to the ambient air, a sec ond opening leading to said bag and a third opening leading to the patient, said first and second openings being aligned and provided in opposite walls of said housing and surrounded by inwardly extending tubular posts, the inner ends of which are aligned in spaced relationship, the tubular post of said second opening bearing on its inner end a peripheral flange provided with through-holes, said inner ends of said tubular posts forming valve seats for an elastic membrane, which is fastened to said peripheral flange in the peripheral area thereof and which alternatively cooperates with one of said tubular posts to alternate between two positions and to act as a double valve, said elastic membrane being biased into its first position by its elastic force, in which first position the elastic membrane sealingly covers said peripheral flange and said inner end of said second tubular post to connect said first opening to said third opening to thereby connect the lungs of the patient to the ambient air, and said elastic membrane being brought into its second position by the air flow from said bag, in which second position the elastic membrane sealingly covers the tubular post of said first opening to connect said second opening via said through-holes to said third opening to thereby connect said bag with the lungs of the patient, the crosssectional area of the tubular post of said second opening leading to said bag being the same or larger than the total cross-sectional area of said through-holes in said peripheral flange.

2. The improvement of claim 1, wherein the crosssectional area of the tubular post of said second opening leading to said bag is 1.2 to 20 times greater than the total cross-sectional area of the passage holes in said peripheral flange.

3. The improvement of claim 1, wherein the peripheral flange is curved.

4. The improvement of claim 1, wherein the elastic membrane is removably connected to the peripheral flange.

5. The improvement of claim 1, wherein the peripheral flange has a peripheral groove for receipt of a ring band arranged on the membrane.

6. The improvement of claim 1, wherein said peripheral flange has on its side remote from membrane a rubbery elastic ring which covers the passage holes of said peripheral flange and which has a slight returning force and which is separated slightly from said peripheral flange by the flow of air leading to the patient.

7. In a resuscitation device for an alternative respiration and external cardiac massage of a patient, comprising a compressible and self-expanding reanimation bag, an adaptation piece for the breathing passage of a patient, a connecting tube connecting said bag to said adaptation piece, a one-way suction valve provided in the assembly defined by said bag and said connecting tube to fill said bag with fresh air during the expansion stroke of said bag, and a double valve provided between said connecting tube and said adaptation piece and adapted to allow the flow of fresh air from said bag into the lungs of the patient when the bag is being compressed, and the re-flow of said air from the lungs of the patient to the ambient air as soon as the bag has reached its collapsed condition, the improvement residing in that said double valve comprises a housing having a first opening leading to the ambient air, a second opening leading to said bag and a third opening leading to the patient, said first and second openings being aligned and provided in opposite walls of said housing and surrounded by inwardly extending tubular posts, the inner ends of which are aligned in spaced relationship, the tubular post of said second opening bearing on its inner end an imperforate peripheral flange, said inner ends of said tubular posts forming valve seats for an elastic membrane, which is fastened to said peripheral flange in the peripheral area thereof and which alternatively cooperates with one of said tubular posts to alternate between two positions and to act as a double valve, said elastic membrane being biased into its first position by its elastic force, in which first position the elastic membrane sealingly covers said peripheral flange and the inner end of said second tubular post to connect said first opening to said third opening to thereby connect the lungs of the patient to the ambient air, said elastic membrane being closed in its central portion and having passage holes in the area where it covers said peripheral flange, and said elastic membrane being brought into its second position by the air flow from said bag, in which second position the elastic membrane sealingly covers the tubular post of said first opening to connect said second opening via said passage holes in said membrane to said third opening to thereby connect said bag with the lungs of the patient, the cross-sectional area of the tubular post of said second opening leading to said bag being the same or greater than the total cross-sectional area of said passage holes in said membrane.

8. The improvement of claim 7, wherein the crosssectional area of the post of said second opening leading to said bag is 1.2 to times greater that. me total cross-sectional area of the passage holes in said elastic membrane.

9. The improvement of claim 7, wherein the peripheral flange is curved.

10. The improvement of claim 7, wherein the elastic membrane is removably connected to the peripheral flange.

11. The improvement of claim 7, wherein the peripheral flange has a peripheral groove for receipt of a ring band arranged on the membrane.

12. In a resuscitation device for an alternative respiration and external cardiac massage of a patient, comprising a compressible and self-expanding reanimation bag, an adaptation piece for the breathing passage of a patient, a connecting tube connecting said bag to said adaptation piece, a one-way suction valve provided in the assembly defined by said bag and said connecting tube to fill said bag with fresh air during the expansion stroke of said bag, and a double valve provided between said connecting tube and said adaptation piece and adapted to allow the flow of fresh air from said bag into the lungs of the patient when the bag is being compressed, and the reflow of said air from the lungs of the patient to the ambient air as soon as the bag has reached its collapsed condition, the improvement residing in that said double valve comprises a housing having a first opening leading to the ambient air, a second opening leading to said bag and a third opening leading to the patient, said first and second openings being aligned and provided in opposite walls of said housing and surrounded by inwardly extending tubular posts, the inner ends of which are aligned in spaced relationship, the tubular post of said second opening bearing on its inner end a peripheral flange, said inner ends of said tubular posts forming valve seats for an elastic membrane, which is fastened to said peripheral flange in the peripheral area thereof and which alternatively cooperates with one of said tubular posts to alternate between two positions and to act as a double valve,-said elastic membrane being biased into its first position by its elastic force, in which first position the elastic membrane sealingly covers said peripheral flange and said inner end of said-second tubular post to connect said first opening to said third opening to thereby connect the lungs of the patient to the ambient air, and said elastic membrane being brought into its second position by the air flow from said bag, in which second position the elastic membrane sealingly covers the tubular post of said first opening and with said flange defining a passage to connect said second opening via said passage to said third opening to thereby connect said bag with the lungs of the patient, the cross-sectional area of the tubular post of said second opening leading to said bag being the same or larger than the total cross-sectional area of said passage.

13. A method for using a resuscitation device consisting of a compressible self-expanding reanimation bag, an adaptation piece for the breathing passages, a connecting tube between said bag and said adaptation piece, and a double valve for respiring a patient as well as a suction valve for feeding air into said bag, which method comprises the steps of (a) closing the nose of the patient air-tightly, (b) supporting said bag on the breastbone of the patient, (c) compressing said bag filled with air by hand of the person doing resuscitation to flow air into the lungs of the patient, (d) pressing down the breastbone several times through the compressed bag by keeping the bag in its collapsed position to effect an external cardiac massage, (e) allowing the bag to return into its expanded condition after having performed external cardiac massage to refill the bag with air, and (f) repeating the steps (c) to (e) in the above turn as long as necessary. 

1. In a resuscitation device for an alternative respiration and external cardiac massage of a patient, comprising a compressible and self-expanding reanimation bag, an adaptation piece for the breathing passage of a patient, a connecting tube connecting said bag to said adaptation piece, a one-way suction valve provided in the assembly defined by said bag and said connecting tube to fill said bag with fresh air during the expansion stroke of said bag, and a double valve provided between said connecting tube and said adaptation piece and adapted to allow the flow of fresh air from said bag into the lungs of the patient when the bag is being compressed, and the re-flow of said air from the lungs of the patient to the ambient air as soon as the bag has reached its collapsed condition, the improvement residing in that said double valve comprises a housing having a first opening leading to the ambient air, a second opening leading to said bag and a third opening leading to the patient, said first and second openings being aligned and provided in opposite walls of said housing and surrounded by inwardly extending tubUlar posts, the inner ends of which are aligned in spaced relationship, the tubular post of said second opening bearing on its inner end a peripheral flange provided with through-holes, said inner ends of said tubular posts forming valve seats for an elastic membrane, which is fastened to said peripheral flange in the peripheral area thereof and which alternatively cooperates with one of said tubular posts to alternate between two positions and to act as a double valve, said elastic membrane being biased into its first position by its elastic force, in which first position the elastic membrane sealingly covers said peripheral flange and said inner end of said second tubular post to connect said first opening to said third opening to thereby connect the lungs of the patient to the ambient air, and said elastic membrane being brought into its second position by the air flow from said bag, in which second position the elastic membrane sealingly covers the tubular post of said first opening to connect said second opening via said through-holes to said third opening to thereby connect said bag with the lungs of the patient, the cross-sectional area of the tubular post of said second opening leading to said bag being the same or larger than the total cross-sectional area of said through-holes in said peripheral flange.
 2. The improvement of claim 1, wherein the cross-sectional area of the tubular post of said second opening leading to said bag is 1.2 to 20 times greater than the total cross-sectional area of the passage holes in said peripheral flange.
 3. The improvement of claim 1, wherein the peripheral flange is curved.
 4. The improvement of claim 1, wherein the elastic membrane is removably connected to the peripheral flange.
 5. The improvement of claim 1, wherein the peripheral flange has a peripheral groove for receipt of a ring band arranged on the membrane.
 6. The improvement of claim 1, wherein said peripheral flange has on its side remote from membrane a rubbery elastic ring which covers the passage holes of said peripheral flange and which has a slight returning force and which is separated slightly from said peripheral flange by the flow of air leading to the patient.
 7. In a resuscitation device for an alternative respiration and external cardiac massage of a patient, comprising a compressible and self-expanding reanimation bag, an adaptation piece for the breathing passage of a patient, a connecting tube connecting said bag to said adaptation piece, a one-way suction valve provided in the assembly defined by said bag and said connecting tube to fill said bag with fresh air during the expansion stroke of said bag, and a double valve provided between said connecting tube and said adaptation piece and adapted to allow the flow of fresh air from said bag into the lungs of the patient when the bag is being compressed, and the re-flow of said air from the lungs of the patient to the ambient air as soon as the bag has reached its collapsed condition, the improvement residing in that said double valve comprises a housing having a first opening leading to the ambient air, a second opening leading to said bag and a third opening leading to the patient, said first and second openings being aligned and provided in opposite walls of said housing and surrounded by inwardly extending tubular posts, the inner ends of which are aligned in spaced relationship, the tubular post of said second opening bearing on its inner end an imperforate peripheral flange, said inner ends of said tubular posts forming valve seats for an elastic membrane, which is fastened to said peripheral flange in the peripheral area thereof and which alternatively cooperates with one of said tubular posts to alternate between two positions and to act as a double valve, said elastic membrane being biased into its first position by its elastic force, in which first position the elastic membrane sealingly covers said peripheral flange and the inner end of said second tubular post to connect saId first opening to said third opening to thereby connect the lungs of the patient to the ambient air, said elastic membrane being closed in its central portion and having passage holes in the area where it covers said peripheral flange, and said elastic membrane being brought into its second position by the air flow from said bag, in which second position the elastic membrane sealingly covers the tubular post of said first opening to connect said second opening via said passage holes in said membrane to said third opening to thereby connect said bag with the lungs of the patient, the cross-sectional area of the tubular post of said second opening leading to said bag being the same or greater than the total cross-sectional area of said passage holes in said membrane.
 8. The improvement of claim 7, wherein the cross-sectional area of the post of said second opening leading to said bag is 1.2 to 20 times greater than the total cross-sectional area of the passage holes in said elastic membrane.
 9. The improvement of claim 7, wherein the peripheral flange is curved.
 10. The improvement of claim 7, wherein the elastic membrane is removably connected to the peripheral flange.
 11. The improvement of claim 7, wherein the peripheral flange has a peripheral groove for receipt of a ring band arranged on the membrane.
 12. In a resuscitation device for an alternative respiration and external cardiac massage of a patient, comprising a compressible and self-expanding reanimation bag, an adaptation piece for the breathing passage of a patient, a connecting tube connecting said bag to said adaptation piece, a one-way suction valve provided in the assembly defined by said bag and said connecting tube to fill said bag with fresh air during the expansion stroke of said bag, and a double valve provided between said connecting tube and said adaptation piece and adapted to allow the flow of fresh air from said bag into the lungs of the patient when the bag is being compressed, and the reflow of said air from the lungs of the patient to the ambient air as soon as the bag has reached its collapsed condition, the improvement residing in that said double valve comprises a housing having a first opening leading to the ambient air, a second opening leading to said bag and a third opening leading to the patient, said first and second openings being aligned and provided in opposite walls of said housing and surrounded by inwardly extending tubular posts, the inner ends of which are aligned in spaced relationship, the tubular post of said second opening bearing on its inner end a peripheral flange, said inner ends of said tubular posts forming valve seats for an elastic membrane, which is fastened to said peripheral flange in the peripheral area thereof and which alternatively cooperates with one of said tubular posts to alternate between two positions and to act as a double valve, said elastic membrane being biased into its first position by its elastic force, in which first position the elastic membrane sealingly covers said peripheral flange and said inner end of said second tubular post to connect said first opening to said third opening to thereby connect the lungs of the patient to the ambient air, and said elastic membrane being brought into its second position by the air flow from said bag, in which second position the elastic membrane sealingly covers the tubular post of said first opening and with said flange defining a passage to connect said second opening via said passage to said third opening to thereby connect said bag with the lungs of the patient, the cross-sectional area of the tubular post of said second opening leading to said bag being the same or larger than the total cross-sectional area of said passage.
 13. A method for using a resuscitation device consisting of a compressible self-expanding reanimation bag, an adaptation piece for the breathing passages, a connecting tube between said bag and said adaptation piece, and a double valve for respiriNg a patient as well as a suction valve for feeding air into said bag, which method comprises the steps of (a) closing the nose of the patient air-tightly, (b) supporting said bag on the breastbone of the patient, (c) compressing said bag filled with air by hand of the person doing resuscitation to flow air into the lungs of the patient, (d) pressing down the breastbone several times through the compressed bag by keeping the bag in its collapsed position to effect an external cardiac massage, (e) allowing the bag to return into its expanded condition after having performed external cardiac massage to refill the bag with air, and (f) repeating the steps (c) to (e) in the above turn as long as necessary. 